| NPI | 1366821936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA ps020010) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: LA 1481) |
| 103TC0700X Psychologist, Clinical (Licence: NY 021172) | |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2024-10-08 |